New Jersey Health Insurance Plans
Find the right health coverage for you and your family in 2026. Compare plans from top Garden State carriers and see if you qualify for savings that could cut your monthly costs significantly.
Your Guide to New Jersey Health Insurance in 2026
Finding the right health plan in New Jersey doesn’t have to be confusing. Whether you’re looking for individual coverage, a family plan, or marketplace options, understanding your choices helps you make a confident decision.
New Jersey residents can get coverage through GetCoveredNJ, the state’s official health insurance marketplace at nj.gov/getcoverednj, or directly from private insurers. The Garden State offers everything from flexible PPO networks to budget-friendly HMO plans that keep costs down while providing quality care.
Here’s something many people don’t realize: over 85% of New Jersey marketplace enrollees qualify for financial help that lowers their monthly premiums. If your household income is between $15,650 and $62,600 for one person (or up to $128,600 for a family of four), you likely qualify for subsidies.
When you compare your options, you’ll see coverage from established carriers like Horizon Blue Cross Blue Shield, AmeriHealth, Oscar Health, UnitedHealthcare, and Ambetter. Each offers different plan designs to match various healthcare needs and budgets across the state.
What’s Changed for 2026 in New Jersey
Several important changes affect how Garden State residents shop for and enroll in health coverage this year. Here’s what you need to know:
Your Own State Marketplace
New Jersey uses GetCoveredNJ (nj.gov/getcoverednj) — not HealthCare.gov. This state-run marketplace offers more local support and unique benefits unavailable elsewhere.
Extended Enrollment Window
Open enrollment runs through January 31, 2026 — two weeks longer than most states. Enroll by December 31 for coverage starting January 1, or in January for February 1 coverage.
State Subsidies Available
NJ Health Plan Savings offers extra financial help for incomes up to 600% FPL — that’s $93,900 for individuals or $192,900 for a family of four. This stacks on top of federal help.
Carrier Lineup Changed
Aetna has exited the NJ marketplace. Five carriers now offer plans: Horizon BCBS, AmeriHealth, Oscar, UnitedHealthcare, and Ambetter from WellCare.
Individual Mandate
New Jersey requires residents to maintain health coverage. Going without insurance (and not qualifying for an exemption) may result in a penalty on your state tax return.
Federal Subsidy Cliff Returns
Enhanced federal subsidies expired. If your income exceeds 400% FPL ($62,600 single / $128,600 family of 4), you no longer qualify for federal premium help — making NJ’s state subsidies even more valuable.
Types of Health Plans Available in New Jersey
Understanding Your Options
New Jersey offers several plan types, each with its own approach to managing your care. Here’s what makes each one different:
HMO (Health Maintenance Organization)
Lower monthly costs with coordinated care through a primary doctor. You’ll need referrals to see specialists, but your out-of-pocket expenses stay predictable. Great for people who want one doctor managing their overall health.
PPO (Preferred Provider Organization)
More freedom to see any doctor or specialist without referrals. You can go out-of-network (for higher costs) if needed. Best for people who travel often or want maximum flexibility in choosing providers. Compare NJ PPO plans.
EPO (Exclusive Provider Organization)
A middle ground between HMO and PPO. No referrals needed for specialists, but you must stay in-network except for emergencies. Good balance of flexibility and cost control.
POS (Point of Service)
Combines HMO coordination with some PPO flexibility. You pick a primary doctor who coordinates care, but can go out-of-network for higher costs. Works well if you want guidance but occasional flexibility.
Metal Tiers: Balancing Premiums and Out-of-Pocket Costs
All marketplace plans fall into “metal tiers” that show how you and your insurer split costs. The tier you choose depends on how often you expect to use healthcare services.
Lower Premiums, Higher Out-of-Pocket
Coverage ratio: Plan pays ~60%, you pay ~40%
Bronze plans offer the lowest monthly premiums but require higher cost-sharing when you use healthcare services. Best for healthy individuals who mainly want protection against major medical emergencies.
Balanced Premiums and Cost-Sharing
Coverage ratio: Plan pays ~70%, you pay ~30%
Silver plans balance monthly costs with out-of-pocket expenses. Qualifying for cost-sharing reductions (CSR) can significantly lower deductibles and copayments, making Silver plans particularly valuable for moderate-income households.
Higher Premiums, Lower Out-of-Pocket
Coverage ratio: Plan pays ~80%, you pay ~20%
Gold plans feature higher monthly premiums but lower costs when accessing care. Well-suited for individuals with regular healthcare needs, ongoing prescriptions, or chronic conditions requiring frequent medical attention.
Highest Premiums, Lowest Out-of-Pocket
Coverage ratio: Plan pays ~90%, you pay ~10%
Platinum plans offer the most comprehensive cost protection with minimal out-of-pocket expenses. Best for individuals with significant anticipated medical needs or those managing serious health conditions.
💰 Cost Comparison Example
Scenario: A 35-year-old New Jersey resident comparing Bronze vs. Silver plans
Bronze Plan: $350/month premium + $7,500 deductible = Higher costs if needing regular care
Silver Plan (with CSR): $420/month premium + $2,800 deductible = Lower overall costs for moderate healthcare use
For someone needing monthly specialist visits and prescriptions, the Silver plan saves approximately $3,500 annually despite higher premiums.
Need Help Selecting the Right Plan Tier?
Our licensed specialists analyze your expected healthcare needs and budget to recommend the most cost-effective coverage tier for your situation.
Get Personalized Recommendations Call: 888-215-4045Top Health Insurance Carriers in New Jersey
Several established insurers offer coverage throughout the Garden State. Here’s how they compare:
| Carrier | Network Size | Plan Types | Best For |
|---|---|---|---|
| Horizon BCBS | Largest in NJ | HMO, PPO, EPO | Those wanting the widest provider choice |
| AmeriHealth NJ | Strong local network | HMO, PPO | Cost-conscious shoppers wanting local care |
| Oscar Health | Growing network | EPO, PPO | Tech-savvy users who prefer digital tools |
| UnitedHealthcare | National + NJ network | HMO, PPO, POS | Frequent travelers or multi-state families |
| Ambetter | Regional network | HMO, EPO | Budget-focused shoppers seeking low premiums |
Carrier Highlights
Horizon Blue Cross Blue Shield
New Jersey’s largest insurer with the most extensive provider network in the state. Offers a wide range of plan options from budget HMOs to comprehensive PPOs.
AmeriHealth New Jersey
Competitive pricing with strong local provider networks. Known for wellness programs and preventive care focus that helps members stay healthy year-round.
Oscar Health
Tech-forward approach with user-friendly apps, easy telemedicine access, and innovative member tools. Popular with younger enrollees who prefer digital-first healthcare.
UnitedHealthcare
National carrier with coverage across New Jersey. Brings access to one of the country’s largest provider networks — helpful if you travel frequently or have family in other states.
Ambetter from WellCare
Budget-friendly options with competitive premiums. Focuses on essential coverage at lower price points, making it a popular choice for cost-conscious shoppers.
What Health Insurance Costs in New Jersey
Health insurance prices in New Jersey depend on several factors. Knowing what affects your rate helps you budget and find potential savings.
| Coverage Type | Average Monthly Premium | With Subsidies |
|---|---|---|
| Individual (Age 30) | $420 – $550 | $50 – $200 |
| Individual (Age 50) | $650 – $850 | $100 – $350 |
| Family of Four | $1,400 – $1,900 | $200 – $600 |
What Affects Your Premium
- Your age: Premiums increase as you get older, with the biggest jumps after age 50
- Where you live: Costs vary by county — northern New Jersey tends to be higher than southern counties
- Plan type: PPO plans cost more than HMOs due to greater flexibility
- Metal tier: Bronze plans have lower premiums but higher out-of-pocket costs
- Tobacco use: Insurers can charge tobacco users up to 50% more
Financial Help Available
Most New Jersey residents qualify for subsidies that significantly reduce monthly costs. Premium tax credits lower your payment based on household income. If you earn between 100% and 250% of the federal poverty level, you may also qualify for cost-sharing reductions (available only with Silver plans) that lower deductibles and copays.
New Jersey Health Plan Savings (State Subsidies)
Beyond federal help, New Jersey offers its own state-funded subsidies called New Jersey Health Plan Savings. These are available to GetCoveredNJ enrollees with household incomes up to 600% of the federal poverty level — that’s $93,900 for an individual or $192,900 for a family of four in 2026. This extra help stacks on top of federal subsidies for even greater savings.
2026 Federal Subsidy Income Limits (100%-400% FPL):
- Single person: $15,650 – $62,600
- Family of two: $21,150 – $84,600
- Family of four: $32,150 – $128,600
New Jersey Individual Mandate
Keep in mind that New Jersey is one of the few states requiring residents to have health insurance. If you go without coverage and don’t qualify for an exemption, you may face a penalty on your state tax return. This makes it especially important to explore your options during open enrollment.
💡 Real Example: How Sarah Saved $4,560/Year
Sarah, a freelance graphic designer in Jersey City, was paying $720/month for a PPO plan she rarely used. After reviewing her situation, we discovered she qualified for a $380/month subsidy she didn’t know existed.
Her new Silver plan costs just $340/month with better prescription coverage for her thyroid medication. That’s $4,560 saved per year — money that now goes toward her business.
See Your Actual Costs With Subsidies Applied
Get a personalized quote showing exactly what you’d pay after tax credits. Takes just 2 minutes.
Calculate My Savings Call: 888-215-4045How to Enroll in New Jersey Health Insurance
2026 Open Enrollment Dates
The main enrollment window runs from November 1, 2025 through January 31, 2026. Enroll by December 31 for coverage starting January 1, or enroll in January for coverage starting February 1.
Special Enrollment Periods
Missed open enrollment? You may still qualify if you’ve experienced a qualifying life event in the past 60 days:
- Lost job-based coverage or aged off a parent’s plan
- Got married or had a baby
- Moved to New Jersey from another state
- Lost Medicaid or CHIP eligibility
- Experienced certain income changes
Getting Expert Help at No Extra Cost
Our licensed New Jersey specialists can walk you through every option and help you find the best fit for your situation. We work with all the major carriers, so you see the same prices you’d find on GetCoveredNJ — but with personalized guidance.
There’s no fee for our help. Insurance companies pay us, not you. That means you get expert advice without any extra cost.
Additional New Jersey Health Insurance Resources
Explore GetCoveredNJ marketplace plans, enrollment rules, subsidies, and qualifying life events.
Individual Health Insurance NJCoverage options for New Jersey individuals and families, including ACA-compliant plans.
Compare NJ QuotesGet personalized health insurance quotes from multiple New Jersey carriers with subsidy estimates.
Self-Employed Coverage NJHealth insurance solutions and tax considerations for New Jersey freelancers and business owners.
New Jersey PPO PlansLearn how PPO plans work in New Jersey, including out-of-network access and flexibility.
Costs & Savings GuideUnderstand premiums, deductibles, subsidies, and strategies to lower NJ health insurance costs.
Ready to Find Your Perfect Coverage?
Our licensed New Jersey specialists are here to help you compare options and find a plan that fits your needs and budget. Get started with a free quote today.
Get Your Free NJ Quote Call Now: 888-215-4045Licensed in New Jersey • Same prices as GetCoveredNJ • Free expert guidance
Independent Broker Notice
ForHealthInsurance.com is an independent health insurance agency serving New Jersey residents. We are not affiliated with any carrier or government agency. We help you compare plans and enroll in coverage that meets your needs.